Triage

Question 1

Define the term Triage

Answer 1

Triage is the process of prioritising sick and injured animals, according to the severity of the illness or injury. If a patient has multiple injuries, the most serious problem is addressed first

Question 2

What’s the first step of triage?

Answer 2

Telephone triage - calm owner, direct questioning
Client details
Why?
When did it start and how did it progress?
Has it happened before?
Medications currently and when was last dose?
Animals demeanour?
Vomit or diarrhoea? What does it look like/ how frequent?
Consciousness?
Wounds? Where and how large?
Can it urinate?

Question 3

What conditions need to be immediately evaluated by a veterinary surgeon?

Answer 3

Unconsciousness 
Seizures
RTA
Profuse haemorrhage
Respiratory distress
Dysuria
Trauma
Unusual behaviour
Pain
Toxin ingestion
Frequent v+/d+ with blood

Question 4

How do owners get to the vets?

Answer 4

It is the owners responsibility to have access to transport in the event of an emergency

Advice should be given regarding transport if special precautions need to be taken eg spinals

Warn against toxin contamination/fear or pain aggression

Always ensure owner is aware of address and practice contact details

Question 5

How long should the primary survey take?

Answer 5

60-90 seconds

Question 6

What does the primary survey involve?

Answer 6

Respiratory
Cardiovascular
Neurological
Temperature

Assess no other systems are affected including urinary

Question 7

What has to be considered in a male cat with vague presenting signs?

Answer 7

Urethral obstruction

Question 8

What presenting signs may a cat with urethral obstruction have?

Answer 8

Hiding
Lethargy
Inappetance
Straining to urinate may go unnoticed by owner

Question 9

What patient details need to taken?

Answer 9

Name
Age
Sex
Breed
Neutering status
Vaccination status
Medical/surgical history
Current problems
Current medication

Question 10

What does the cardiovascular examination assess?

Answer 10

The cardiovascular system examination enables assessment of the haemodynamic stability of a patient.
Blood flow to body tissues (perfusion) is vital to supply sufficient oxygen for normal cellular activity and therefore patient survival.

Question 11

What is me tat ion dependent on?

Answer 11

Appropriate blood flow to the brain

Question 12

What are the levels of consciousness?

Answer 12

Normal
Depressed - not appropriately responsive to stimuli
Obtunded - decreased consciousness but rousable with non-noxious stimuli
Stuporous - unconscious but rousable with noxious stimuli
Comatose- not responsive to noxious stimuli
Hyperexciteable - excessive reaction to stimuli

Question 13

What do pale mms suggest

Answer 13

Anaemia

Hypoperfusion usually caused by hypovolaemia leading to peripheral vasoconstriction

Question 14

What do yellow mms suggest

Answer 14

Icterus/jaundice

Liver dx, excessive haemolysis, biliary tract dx

Question 15

What do bright red mms suggest

Answer 15

Early sepsis/ SIRS in dogs

Question 16

What do blue/ purple mms suggest

Answer 16

Cyanosis
Severe hypoxaemia
Secondary to deoxygenated haemoglobin

Question 17

What do brick red mms suggest

Answer 17

Carbon monoxide poisoning

Question 18

What do brown mms suggest

Answer 18

Paracetamol toxicity (methaemaglobinaemia)

Question 19

What do tacky or dry mms suggest

Answer 19

Dehydration

Does not necessarily mean hypovolaemia

Question 20

What does the CRT mean?

Answer 20

Amount of time for the blood to return back to the capillary bed after being forced out by digital pressure

Question 21

What does prolonged crt suggest

Answer 21

> 2 secs

Hypoperfusion / shock if mms also pale

Question 22

What does rapid crt suggest?

Answer 22

Sepsis

Question 23

Define the term shock

Answer 23

Lack of oxygen delivery to cells/ tissues. Decreased cell oxygenation causes organ dysfunction and cell death.
If untreated, this will result in multiple organ dysfunction (MOD) and patient death.

Question 24

What heart rate is classed as tachycardia in dogs?

Answer 24

140bpm but dog dependant

A constant tachycardia is less worrying than an irregular tachycardia

Question 25

What is a common cause of tachycardia?

Answer 25

Hypoperfusion/ shock

Question 26

What is inappropriate bradycardia?

Answer 26

When a heart rate is normal where tachycardia is expected eg hypovolaemic shock

Question 27

What can cause bradycardia?

Answer 27

Hyperkalaemia
Drugs eg lidocaine 
Increased vagal tone
Atrioventricular block
Hypothermia 
Sick sinus syndrome 
Raised intracranial pressure

Question 28

Causes of tachycardia in cats

Answer 28

Hyperthyroidism 
Congestive heart failure
Intoxications
Electrolyte disturbances
Pain 
Stress

Question 29

Causes of bradycardia in cats

Answer 29

Septic shock
Sepsis
Hyperkalaemia (urethral obstruction)
Hypothermia
High vagal tone